Be open about dental discipline

AVancouver woman, Kathe Atkinson, is suing her former dentist for what she claims was shoddy work. After visiting Dr. Steven Krieger to have her teeth whitened, she was told she also needed several old fillings replaced. But after having the new fillings installed, she began to experience severe pain that lasted the better part of three years.

After losing confidence in Krieger, she visited other dentists and underwent several root canals, but the pain continued. Eventually, she had the teeth extracted.

When Atkinson complained to the B.C. College of Dental Surgeons — the professional body that oversees the work of dentists in this province — she discovered that the college had “competency concerns” about Krieger. She was advised that he had been ordered to take an “extensive educational program” and to complete two mentorships under other dentists. She was also told he would be monitored by the college for 30 months while his performance was assessed.

Then it turned out another dentist who took over Krieger’s practice also had concerns about his predecessor’s work. He reported this matter to the college, and eventually a total of eight former patients, Atkinson among them, filed lawsuits against Krieger.

It’s important to note that Krieger has denied the allegations, and that so far nothing has been proven. He is therefore entitled to the presumption of innocence.

The question that should concern us is whether the college is doing its job adequately. When complaints of malpractice are lodged — and about 220 were received last year — they are examined by an inquiry team, two-thirds of whom are practitioners and one-third members of the public. Most issues are usually resolved to the satisfaction of both parties.

However, a few are sometimes considered grave enough to warrant major disciplinary action — there were 25 such cases last year. Details of these complaints, along with the actions taken and the dentists’ names, are published on the college’s website.

But this is where the concerns start. It appears to take a very serious complaint indeed before the college actually names names.

Here are a few of the findings that did make it onto the published list of disciplinary actions. One dentist admitted to having a sexual relationship with a patient, then faking an insurance claim to save the woman money.

Another admitted to a far-reaching falsification of patient records so he might gain permission to administer sedation. Yet another admitted to billing numerous patients or their insurers for treatments that were unnecessary.

These are virtually the definition of malpractice. In any profession, they should result in heavy penalties. Yet in these instances, the strongest disciplinary measure imposed was a one-month suspension.

And that raises another question — what else is going on that we don’t get to hear about? For example, although the college told Atkinson about the disciplinary measures it had taken in Krieger’s case, these are not mentioned on the college’s website. Only the most serious actions are made public.

Other provinces have dealt with this problem by demanding that professional oversight bodies open their books in a more transparent way. B.C. should follow their example.

There is also a fairness issue. The college’s disciplinary process is staffed heavily by practitioners. Members of the public are always in a minority on any review team. There is an inherent conflict of interest in such a tilted field.

That might not matter so long as the matters at hand are either training-related or deal with scope of practice. These are technical issues that require experience in the field.

But complaints of malpractice are different. They should be adjudicated in a forum that is not so visibly stacked against the patient.